Department of Pediatric Dentistry, Faculty of Dentistry, Marmara University, Basibuyuk yolu, 9/3, Maltepe, Istanbul 34854, Turkey.
Private Practice, Istanbul, Turkey.
J Dent. 2024 May;144:104919. doi: 10.1016/j.jdent.2024.104919. Epub 2024 Mar 1.
This study aimed to assess the clinical performance outcome at 36 months of molars with molar incisor hypomineralization and carious lesions, treated with two different restorative approaches following selective caries removal.
The children aged 6 to 12 years (18 female, 13 male) included in the study had at least two carious permanent first molars diagnosed with molar incisor hypomineralization. Sixty-two molars were restored in a split-mouth design. In all subjects, selective caries removal was performed so that caries was completely removed from the cavosurface walls and only soft dentin was left above the pulp chamber. Short fiber reinforced composite (SFRC; EverX Flow™) covered by micro-hybrid composite (G-Aenial® posterior composite) and Glass Hybrid (GH; Equia Forte® HT) were used as restorative materials. The restorations were evaluated according to modified United States Public Health Service (USPHS) criteria at baseline, 6, 12, 18, 24, and 36 month follow-ups.
During the 36-month follow-up, eight GH and four SFRC restorations failed. The clinical success of both restorations decreased statistically over time (p < 0.001 for both). When variables such as restoration type, sex, age, tooth type, and time were included in the model, the risk of failure of the restorations of the left lower first molar was statistically significantly higher than that of the left upper first molar (p < 0.002).
Direct composite restorations with SFRC and GH restorations perform similar clinical success with selective caries removal in the management of permanent molars affected by molar incisor hypomineralization.
SFRC or GH restorations with similar clinical success might be preferred for the management of MIH-affected molars.
本研究旨在评估经选择性龋去腐后,采用两种不同修复方法对磨牙牙本质发育不全伴龋损磨牙 36 个月的临床疗效。
本研究纳入年龄为 6 至 12 岁(女 18 例,男 13 例)的至少有两颗患龋的恒牙第一磨牙,诊断为牙本质发育不全。采用劈裂口设计对 62 颗磨牙进行修复。所有患者均行选择性龋去腐,使窝沟侧壁的龋坏完全去除,仅在牙髓腔上方留有软龋。短纤维增强型复合树脂(EverX Flow™)覆盖微混合复合树脂(G-Aenial®后牙复合树脂)和玻璃混合复合树脂(GH;Equia Forte® HT)被用作修复材料。修复体根据改良美国公共卫生署(USPHS)标准在基线、6、12、18、24 和 36 个月随访时进行评估。
在 36 个月的随访期间,有 8 颗 GH 修复体和 4 颗 SFRC 修复体失败。两种修复体的临床成功率均随时间呈统计学下降(均为 p < 0.001)。当将修复体类型、性别、年龄、牙位和时间等变量纳入模型时,左侧下颌第一磨牙的修复体失败风险明显高于左侧上颌第一磨牙(p < 0.002)。
在磨牙牙本质发育不全的治疗中,采用选择性龋去腐后,SFRC 和 GH 直接复合树脂修复体的临床成功率相似。
SFRC 或 GH 修复体具有相似的临床成功率,可能更适合治疗 MIH 受累磨牙。